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LINK After School Application 2020-2021
Distance Learning for PreK - 6th grade
Beginning September 14
Live Online Programming Monday-Friday, 3 p.m. to 5 p.m.
Learning Totes for PreK & K
At-home, No Tech Activities
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Student Information
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Additional Student/Sibling Information
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Household & Permissions
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Student Information
2
Additional Student/Sibling Information
3
Household & Permissions
Student Name
First
Last
Date of Birth
MM
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DD
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YYYY
Grade (2020-2021 School Year)
Please select
PreK
K
1st
2nd
3rd
4th
5th
6th
School Name
Please select
Baltimore Design School
Barclay
Bryn Mawr
Cardinal Shehan School
City Neighbors Charter
City Neighbors Hamilton Charter School
Dallas F. Nicholas
Dayspring Headstart
Doctor Bernard Harris Senior Elementary
East Baltimore Community School
Freedom Elementary
Govans Elementary
Hamilton Elem/Middle
John B Kelly
Johnson Square
KIPP Ujima
Leith Walk Elementary
Margaret Brent
Monarch Academy
Northwood Appold Charter School
Other
Red House Run Elementary
Ridgely Middle
Riverside Elementary
Roland Park Elementary
Southwest Baltimore Charter School
Stoneleigh Elementary
The Green School
Thomas Johnson
Tunbridge Public Charter
William Pinderhughes Elementary
If "Other," please list.
BCPSS Student ID Number
You can find the student ID number on a report card, a progress report, by logging into your BCPS portal, or by calling your school.
If you do not have the number at this time, please leave the field blank, and note that students will not be allowed to attend until this number has been submitted.
BCPSS Student Email Address
If you do not have your student's BCPSS email address at this time, please leave the field blank.
Allergies and Medical Conditions
If your child has food or medicine allergies, or medical conditions, then list them above.
Inclusion and Special Services
The Village Learning Place’s programs seek to create an inclusive and welcoming environment that helps youth of all abilities. Everyone is welcome to enroll. If your student needs to have special accommodations made to allow him/her to participate, we will be happy to work with you.
Our staff uses the information you provide to help students get the most out of their summer learning experience.
Educational Services
IEP
BIP/BSP
504
ESOL
Speech
Services for ADD/ADHD
Other
Does your child receive any special education services (IEP, 504, speech, etc.) at school or other supportive services?
If no, then please skip this section.
If "Other," please list below.
Self-Identification Data and Collection Form
Please answer the following questions. This information will be used to determine whether the benefits of this program are being made available to all people on a non-discriminatory basis. Further, the information being collected is a requirement by funders of this program, and part of our continued efforts to remain in compliance with their guidelines.
Remaining in compliance is the only way that we are allowed to effectively conduct this service and continue to provide this FREE program to you, your child(ren), and this community.
The Village Learning Place (VLP) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance program.
None of this information will be shared outside of our program. We report demographics in terms of numbers, and not attached to identifying information.
Thank you for your understanding. If you have feedback about how we can make this from more inclusive, please share it in the space provided at the end.
Gender
Please select
Female
Male
Gender nonconforming
Something else
Decline to answer
Race
What categories describe the student?
(Select all that apply).
American Indian/Alaskan Native (e.g Navajo Nation, Blackfeet Tribe, Mayan, etc.)
Asian (e.g. Chinese, Filipino, Asian Indian, etc.)
Black/ African American (e.g. African American, Haitian, Ethiopian, etc.)
Bi or Multi Racial
Hispanic, Latino, or Spanish origin (e.g. Cuban, Mexican-American, Salvadoran, etc.)
Native Hawaiian/ Pacific Islander (e.g. Samoan, Guamanian, Chamorro, Fijian, etc.)
White (e.g. German, English, Polish, etc.)
Some other race, ethnicity, or origin
Prefer not to say
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